Resectoscopic treatment of atypical endometrial polyps in fertile women.
OBJECTIVE
The purpose of this study was to evaluate the long-term efficacy and prognosis of hysteroscopic resection and coagulation of the base of endometrial polyps with focal atypia in fertile women with or without progestin suppression.


METHODS
We conducted a quasi-randomized trial in which conservative treatment was offered to 21 patients who had endometrial polyps with focal atypia and a surrounding normal endometrium. The polyps were analyzed separately from their bases. Random biopsy specimens were taken from 4 standard places of the endometrium.


RESULTS
Eighteen women (10 women with an intrauterine device and 8 women with no intrauterine device) completed the follow-up procedure. After 5 years, we found no difference in the 2 groups regarding recurrence of atypical polyps.


CONCLUSIONS
Conservative resectoscopic treatment may be considered in fertile women with atypical polyps if polyp base and surrounding endometrium are benign. If women want to become pregnant at short term, the use of progestins can be delayed, with a strict follow-up procedure. Larger studies should be encouraged.
Scrimin
Federica
F
Department of Obstetrics and Gynecology, Institute of Child Health, IRCCS Burlo Garofolo, Trieste, Italy. scrimin@burlo.trieste.it
Wiesenfeld
Uri
U
Candiotto
Alberto
A
Inglese
Stefania
S
Ronfani
Luca
L
Guaschino
Secondo
S
D000328:Adult; D004564:Electrocoagulation / Q000379:methods*; D004714:Endometrial Hyperplasia / Q000473:pathology / Q000601:surgery*; D004717:Endometrium / Q000187:drug effects / Q000473:pathology; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D016912:Levonorgestrel / Q000494:pharmacology; D008875:Middle Aged; D011127:Polyps / Q000473:pathology / Q000601:surgery*; D011379:Prognosis
D016912:Levonorgestrel